Cargando…
Sevoflurane, Propofol and Carvedilol Block Myocardial Protection by Limb Remote Ischemic Preconditioning
The effects of remote ischemic preconditioning (RIPC) in cardiac surgery have been inconsistent. We investigated whether anesthesia or beta-blockers interfere with RIPC cardioprotection. Fifty patients undergoing cardiac surgery were randomized to receive limb RIPC (four cycles of 5-min of upper arm...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359553/ https://www.ncbi.nlm.nih.gov/pubmed/30641885 http://dx.doi.org/10.3390/ijms20020269 |
_version_ | 1783392286236737536 |
---|---|
author | Cho, Youn Joung Nam, Karam Kim, Tae Kyong Choi, Seong Woo Kim, Sung Joon Hausenloy, Derek J Jeon, Yunseok |
author_facet | Cho, Youn Joung Nam, Karam Kim, Tae Kyong Choi, Seong Woo Kim, Sung Joon Hausenloy, Derek J Jeon, Yunseok |
author_sort | Cho, Youn Joung |
collection | PubMed |
description | The effects of remote ischemic preconditioning (RIPC) in cardiac surgery have been inconsistent. We investigated whether anesthesia or beta-blockers interfere with RIPC cardioprotection. Fifty patients undergoing cardiac surgery were randomized to receive limb RIPC (four cycles of 5-min of upper arm cuff inflation/deflation) in the awake state (no-anesthesia; n = 17), or under sevoflurane (n = 17) or propofol (n = 16) anesthesia. In a separate crossover study, 11 healthy volunteers received either carvedilol or no medication prior to RIPC. Plasma dialysates were obtained and perfused through an isolated male Sprague–Dawley rat heart subjected to 30-min ischemia/60-min reperfusion, following which myocardial infarct (MI) size was determined. In the cardiac surgery study, pre-RIPC MI sizes were similar among the groups (39.7 ± 4.5% no-anesthesia, 38.9 ± 5.3% sevoflurane, and 38.6 ± 3.6% propofol). However, post-RIPC MI size was reduced in the no-anesthesia group (27.5 ± 8.0%; p < 0.001), but not in the anesthesia groups (35.7 ± 6.9% sevoflurane and 35.8 ± 5.8% propofol). In the healthy volunteer study, there was a reduction in MI size with RIPC in the no-carvedilol group (41.7 ± 4.3% to 30.6 ± 8.5%; p < 0.0001), but not in the carvedilol group (41.0 ± 4.0% to 39.6 ± 5.6%; p = 0.452). We found that the cardioprotective effects of limb RIPC were abolished under propofol or sevoflurane anesthesia and in the presence of carvedilol therapy. |
format | Online Article Text |
id | pubmed-6359553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-63595532019-02-06 Sevoflurane, Propofol and Carvedilol Block Myocardial Protection by Limb Remote Ischemic Preconditioning Cho, Youn Joung Nam, Karam Kim, Tae Kyong Choi, Seong Woo Kim, Sung Joon Hausenloy, Derek J Jeon, Yunseok Int J Mol Sci Article The effects of remote ischemic preconditioning (RIPC) in cardiac surgery have been inconsistent. We investigated whether anesthesia or beta-blockers interfere with RIPC cardioprotection. Fifty patients undergoing cardiac surgery were randomized to receive limb RIPC (four cycles of 5-min of upper arm cuff inflation/deflation) in the awake state (no-anesthesia; n = 17), or under sevoflurane (n = 17) or propofol (n = 16) anesthesia. In a separate crossover study, 11 healthy volunteers received either carvedilol or no medication prior to RIPC. Plasma dialysates were obtained and perfused through an isolated male Sprague–Dawley rat heart subjected to 30-min ischemia/60-min reperfusion, following which myocardial infarct (MI) size was determined. In the cardiac surgery study, pre-RIPC MI sizes were similar among the groups (39.7 ± 4.5% no-anesthesia, 38.9 ± 5.3% sevoflurane, and 38.6 ± 3.6% propofol). However, post-RIPC MI size was reduced in the no-anesthesia group (27.5 ± 8.0%; p < 0.001), but not in the anesthesia groups (35.7 ± 6.9% sevoflurane and 35.8 ± 5.8% propofol). In the healthy volunteer study, there was a reduction in MI size with RIPC in the no-carvedilol group (41.7 ± 4.3% to 30.6 ± 8.5%; p < 0.0001), but not in the carvedilol group (41.0 ± 4.0% to 39.6 ± 5.6%; p = 0.452). We found that the cardioprotective effects of limb RIPC were abolished under propofol or sevoflurane anesthesia and in the presence of carvedilol therapy. MDPI 2019-01-11 /pmc/articles/PMC6359553/ /pubmed/30641885 http://dx.doi.org/10.3390/ijms20020269 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cho, Youn Joung Nam, Karam Kim, Tae Kyong Choi, Seong Woo Kim, Sung Joon Hausenloy, Derek J Jeon, Yunseok Sevoflurane, Propofol and Carvedilol Block Myocardial Protection by Limb Remote Ischemic Preconditioning |
title | Sevoflurane, Propofol and Carvedilol Block Myocardial Protection by Limb Remote Ischemic Preconditioning |
title_full | Sevoflurane, Propofol and Carvedilol Block Myocardial Protection by Limb Remote Ischemic Preconditioning |
title_fullStr | Sevoflurane, Propofol and Carvedilol Block Myocardial Protection by Limb Remote Ischemic Preconditioning |
title_full_unstemmed | Sevoflurane, Propofol and Carvedilol Block Myocardial Protection by Limb Remote Ischemic Preconditioning |
title_short | Sevoflurane, Propofol and Carvedilol Block Myocardial Protection by Limb Remote Ischemic Preconditioning |
title_sort | sevoflurane, propofol and carvedilol block myocardial protection by limb remote ischemic preconditioning |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359553/ https://www.ncbi.nlm.nih.gov/pubmed/30641885 http://dx.doi.org/10.3390/ijms20020269 |
work_keys_str_mv | AT choyounjoung sevofluranepropofolandcarvedilolblockmyocardialprotectionbylimbremoteischemicpreconditioning AT namkaram sevofluranepropofolandcarvedilolblockmyocardialprotectionbylimbremoteischemicpreconditioning AT kimtaekyong sevofluranepropofolandcarvedilolblockmyocardialprotectionbylimbremoteischemicpreconditioning AT choiseongwoo sevofluranepropofolandcarvedilolblockmyocardialprotectionbylimbremoteischemicpreconditioning AT kimsungjoon sevofluranepropofolandcarvedilolblockmyocardialprotectionbylimbremoteischemicpreconditioning AT hausenloyderekj sevofluranepropofolandcarvedilolblockmyocardialprotectionbylimbremoteischemicpreconditioning AT jeonyunseok sevofluranepropofolandcarvedilolblockmyocardialprotectionbylimbremoteischemicpreconditioning |